In the New England Journal of Medicine, Matthew McCoy and colleagues, including Ezekiel Emanuel, examine conflicts of interest arising from the presence of industry executives on the boards of patient-advocacy organizations. Previous research has raised concern that the presence of industry leaders on the boards of these non-profit organizations may lead to advocacy for questionable reforms that do not always benefit the organizations’ constituents. The authors analyzed tax records, annual reports, and websites of 104 of the largest U.S patient-advocacy organizations to understand...

In Gastroenterology, Marina Serper and colleagues, including David Goldberg, assess how various health care system factors affect survival rates in hepatocellular carcinoma (HCC). These factors included uptake of historically underutilized curative therapies, access to a hepatologist, and presentation of the case to a multidisciplinary tumor board. The authors found that, while curative treatments of HCC increased survival rates, only 25% of newly diagnosed HCC patients received treatment intended to cure the disease. Additionally, those who received care from only...

In Journal of Palliative Medicine, Salimah Meghani and colleagues identify and review available palliative care-related smartphone applications for clinicians. The authors assess growth in development of these apps, and review them for purpose, target audience, and number of downloads. They found that the number of palliative care apps targeting clinicians has increased eight-fold over the past five years. Of the 46 applications identified, nine were designed to assist clinicians with goals of advance care planning, seven provide training materials for palliative care, 17 present...

In PLOS Medicine, Aaron Kesselheim and colleagues, including LDI senior fellow Steven Joffe, investigate the policy and economic implications of the Orphan Drug Act of 1983, and examine the circumstances surrounding a drug’s discovery and development, secondary approvals, off label uses, subsequent revenues, and the reported monthly cost of biomarker-defined disease subsets. The Orphan Drug Act of 1983 was intended to incentivize the development of pharmaceutical products for rare diseases by providing manufacturers with the opportunity to earn grants, tax credits, free waivers,...

What exactly is precision medicine? When the human genome was sequenced more than a decade ago, it began a new era of medicine that is now known as precision medicine. Initially, it was called personalized medicine; however, the word “personalized” was replaced with “precision” because it caused confusion and was misinterpreted. The goal of precision medicine is not to develop preventions and treatments that are unique for each individual. The National Research Council defines precision medicine as a medical model that focuses on “identifying which approaches will be effective for which...

In a harshly worded letter released Monday, the Food and Drug Administration (FDA) ordered the company 23andMe to “immediately discontinue marketing” its saliva spit test (from which a consumer’s DNA is isolated) and personalized genome service until it provides the FDA with requested information on safety and effectiveness. I asked Reed Pyeritz, MD, PhD, a medical geneticist at Penn and former president of the American College of Medical Genetics, to comment on this development. He wrote: